Issues and challenges for development of a sustainable service model for people with spinal cord injury living in rural regions.
OBJECTIVE
To develop and implement a service model for people with spinal cord injury (SCI) living in rural regions.


METHODS
Service development, pilot evaluation study.


METHODS
Regional and remote areas of the state of New South Wales, Australia.


METHODS
Persons with SCI, caregivers, and health professionals.


METHODS
Phase 1 included initial needs analysis, followed by education and resource development tailored to needs of rural health professionals, caregivers, and persons with SCI. Phase 2 included coordination, professional support, and network development by part-time rural key worker and metropolitan-based project officer, documenting health- and service-related issues.


METHODS
Self-perception of confidence as a result of education as well as reported issues, adverse health events, and barriers to service provision.


RESULTS
Clinician confidence in managing people with SCI improved after education. Various health-related, environmental, and psychosocial issues were reported. Limited availability of resources and health infrastructure, particularly in more isolated or smaller towns, challenged service provision. Rural key workers played a central role in supporting local clinicians and service providers, improving communication and service coordination between rural health professionals and metropolitan SCI services.


CONCLUSIONS
Education and support for rural workforce that may be limited in numbers and capacity, and a model facilitating communication and coordination between services, are essential for improving health outcomes of rural people with SCI.
Middleton
James W
JW
Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, Sydney, Australia. j.middleton@usyd.edu.au
McCormick
Melissa
M
Engel
Stella
S
Rutkowski
Susan B
SB
Cameron
Ian D
ID
Harradine
Peter
P
Johnson
Jennifer L
JL
Andrews
David
D
D005260:Female; D006801:Humans; D008297:Male; D020380:Needs Assessment; D009517:New South Wales; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D019035:Rural Health Services / Q000458:organization & administration*; D013119:Spinal Cord Injuries / Q000534:rehabilitation*